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Denying Children’s Health Care

The Bush administration reached a deplorable, preordained verdict yesterday when it denied New York State permission to expand a valuable health insurance program to help cover middle-class children. The administration, which makes no effort to disguise its disdain for government insurance programs, imposed new, excessively stringent requirements last month that not only guaranteed New York’s denial but will make it nearly impossible for any state to expand coverage.

The denial shows the White House at its most ideological and intransigent. Unfortunately, tens of thousands of children in New York — and many more nationally — will end up paying the price.

New York wanted to raise its income threshold for the State Children’s Health Insurance Program, or S-chip, from the current $51,000 for a family of four to more than $82,000. There is room to debate whether that level — four times the poverty level — is too high, but the administration is not basing its rejection on those grounds. Federal officials say they have no authority to reject a state’s plan based on income eligibility alone.

That is apparently why the administration cooked up new requirements that allow it to block middle-class coverage on other grounds. This is a distressing change for a program that had previously given states great leeway to devise coverage to fit their own circumstances.

The administration’s first reason for denying New York’s request was that the state has failed to show that it has enrolled at least 95 percent of all the children below 200 percent of the poverty level before moving the eligibility bar to higher incomes. New York says it has one of the country’s highest participation levels — at 88 percent — which sounds plenty good enough to justify reaching higher. So far as we know, no state has met the 95 percent level and many experts think it is unattainable in a group that is difficult to reach and motivate.

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Another ground for denial — that New York had failed to require that children above 250 percent of poverty be uninsured for a full year before enrollment — may be the most irrational of all. The administration claims that its goal is to make sure that families don’t drop existing group health coverage to enroll in S-chip. But one year is too long for any child to go without insurance with the likely result that medical needs will be ignored. At one point the state — unwisely in our view — reluctantly offered to extend its proposed six-month waiting period to a full year provided the administration would grant exceptions for children who lose their private coverage involuntarily, as when a parent dies or loses a job. No dice.

The administration seemed more intent on blocking the program than finding a reasonable compromise.

New York can petition for reconsideration, and probably should, though the likelihood that the administration might change its mind is vanishingly small. State officials should also consider a legal challenge.

The best guarantee of success — and protection for America’s children — would be for Congress to block implementation of the White House’s arbitrary and destructive new requirements, perhaps in S-chip reauthorization bills that are now before a conference committee. If that can’t be done by a veto-proof margin, voters will have to elect more legislators committed to solving the health care crisis afflicting middle-class families.

A version of this editorial appears in print on , on Page A14 of the New York edition with the headline: Denying Children’s Health Care. Today's Paper|Subscribe